Organization Active NPI

Southern Trinity Area Rescue Inc

  • Land Ambulance
  • Mad River, CA
National Provider Identifier
1124910542
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
SOUTHERN TRINITY AREA RESCUE INC
Practice address
321 Van Duzen Rd
Mad River, CA 95526-9508
Phone
(707) 296-8060
NPI assigned
Jul 18, 2025
Last updated
Jul 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brooke Entsminger
Title
EMS Manager
Phone
(707) 296-8060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

321 Van Duzen Rd
Mad River, CA 95526-9508

Mailing address

PO Box 269110
Sacramento, CA 95826-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260512002501 CA Part B Supplier - Ambulance Service Supplier 0840769584 Practice locations: Mad River, CA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1124910542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958269110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 VAN DUZEN RD",
            "city": "MAD RIVER",
            "state": "CA",
            "postal_code": "955269508",
            "telephone_number": "707-296-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TRINITY AREA RESCUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "ENTSMINGER",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "EMS MANAGER",
        "authorized_official_telephone_number": "707-296-8060"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mad River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.